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Aims: To assess the prevalence of burnout and associated factors among healthcare workers (HCWs) working in a hospital admitting patients with COVID‐19. Background: Burnout among HCWs is related to age, gender and occupation. However, little is known about organisational factors associated with burnout during the COVID‐19 pandemic. Design: A cross‐sectional study of 1412 hospital HCWs (748 nurses) was carried out via online survey during the COVID‐19 pandemic between 4 and 19 January 2021. Methods: The Maslach Burnout Inventory‐Human Services Survey, the Checklist Individual Strength questionnaire, the interRAI items covering mental health, the WHO questionnaire items assessing HCWs' preparedness and exposure to SARS‐CoV‐2 were used. Univariable and multivariable linear regression analyses were conducted to clarify factors associated with emotional exhaustion (EE), depersonalisation (DP) and personal accomplishment (PA). This study adheres to the STROBE guidelines. Results: Burnout prevalence varied from 10.0% to 22.0%. Most respondents (83.6%) reported low PA, 22.9% high EE and 18.7% high DP. Nurses and physicians had the highest levels of EE and DP. Staff exposed or uncertain if exposed to contaminated patients' body fluids and materials had higher levels of burnout. Preparedness (training) (b = 1.15; 95%CI 0.26 to 2.05) and adherence to infection prevention and control procedures (b = 1.57; 95%CI 0.67 to 2.47) were associated with higher PA, and accessibility of personal protective equipment (PPE) (b = −1.37; 95%CI ‐2.17 to −0.47) was related to lower EE. HCWs working in wards for patients with COVID‐19 reported lower EE (b = −1.39; 95%CI ‐2.45 to −0.32). HCWs who contracted COVID‐19 reported lower DP (b = −0.71, 95%CI ‐1.30 to −0.12). Conclusions: Organisational factors such as better access to PPE, training, and adherence to infection prevention and control procedures were associated with a lower level of burnout. Relevance to clinical practice: Healthcare managers should promote strategies to reduce burnout among HCWs with regard to preparedness of all staff. [ABSTRACT FROM AUTHOR]

Aim: To provide initial data regarding country‐specific evidence of workplace violence towards nurses working within the health sector in five European countries. Methods: This is a descriptive and cross‐sectional pilot study, conducted in June 2016. The sample consisted of 260 nurses working in selected health care settings in five participating countries (Poland, Czech Republic, Slovakia, Turkey, and Spain). The questionnaire used was adapted from the International Labour Office/International Council of Nurses/World Health Organisation/Public Services International Workplace Violence in the Health Sector Country Case Study—Questionnaire. Results: A large number of participants confirmed that they had been physically attacked or verbally abused in the workplace in the last 12 months. In most cases, the physical and verbal abuse was inflicted by patients and to a lesser degree by relatives of patients, staff members, or managers/supervisors. In the majority of cases, no action was taken to investigate the causes of the incidents. In most cases, participants believed there was no point in reporting the incidents. However, the reasons for not reporting or discussing incidents of workplace violence varied depending on the country. Conclusion: Workplace violence towards nurses is a serious problem internationally, and violence prevention strategies need to be implemented. SUMMARY STATEMENT: What is already known about this topic? The nursing profession is at high risk of workplace violence. However, the problem seems to be severely underreported.What this paper adds? A better understanding of the problem in the social and cultural context, together with data fill information gaps regarding workplace violence in selected European countries.The implications of this paper: On the basis of the data obtained, prevention programmes and recommendations can be established and implemented in nurses' daily lives. Evaluation can also be conducted of the effectiveness of existing programmes and standards. [ABSTRACT FROM AUTHOR]

Background and Aim: With the worldwide outbreak of coronavirus, a significant impact has been observed on the functioning of healthcare systems and the process of childbirth. Women probably did not even have a choice to adjust their plans accordingly to the current situation. The aim of the study was to examine how the outbreak of the SARS CoV‐2 pandemic state affected the decisions of pregnant women about their childbirth plan. Design: This cross‐sectional study was performed using a web‐based survey published on social media in Poland. Methods: The cross‐sectional study was performed using web‐based questionnaires. The study group included Polish women who changed their childbirth plans, compared to a group of women not sure about delivery plan change and those whose plans had not changed. The data were collected from 4 March 2020 to 2 May 2020, when the first rising count of new infections was observed in Poland and worldwide. Statistical analysis was performed using STATISTICA Software, Inc., 13.3 (2020). Results: Of 969 women who completed the questionnaire and were enrolled into the study, 57.2% had not changed their childbirth plans (group I), 28.4% had changed their plans (group II), and 14.4% of respondents answered "not sure" to this question (group III). The majority of women changed their birth plans during the pandemic because of the potential absence of their partner during labour (56% of women who had changed their plans and 48% of those whose answer was "I am not sure", p <.001). Another reason was the fear of separation from the child after delivery (33% of women who had changed their plans and 30% of those whose answer was "I am not sure", p <.001). Conclusion: Restrictions due to the COVID‐19 outbreak have influenced the childbirth plans of pregnant women. The changes were independent of women's vision of birth before the pandemic. Impact: The restriction on births with accompanying person and the risk of separation from their infant after childbirth significantly influenced the decision‐making process. As a result, some women were more likely to opt for a home birth with or even without medical assistance. Patient or Public Contribution: The study participants were women who were pregnant at the time of completing the questionnaire, were over 18 years old and spoke Polish. [ABSTRACT FROM AUTHOR]

Aims and objectives: This study aimed to analyse and evaluate the functioning of long‐term at‐home nursing care (LTHNC) based on the opinions of its service providers. Background: Long‐term at‐home nursing care is a form of care for patients who do not need hospital treatment but need systematic nursing care because of their health problems. LTHNC in Poland involves guaranteed care services financed from universal health insurance contributions pursuant to contracts with the National Health Fund (NHF); the program has existed since 2004. Design: A sequential‐explanatory mixed‐method design was used. The study was carried out using both quantitative and qualitative research methods. Methods: A questionnaire was distributed amongst 1119 care providers (the response rate was 38.2%). The qualitative research comprised semi‐structured interviews with ten care providers, namely three nurses managing LTHNC facilities and seven nurses directly providing services as part of LTHNC. The STROBE checklist was used in reporting this study. Results: We found that the main reasons for contracting LTHNC services were the increasing demand for this form of care, financial motives and an opportunity to introduce new organisational solutions. Our study shows that LTHNC is beneficial not only for the patients, but also for the nurses who provide the care. On the one hand, LTHNC provides positive results for patients and their caregivers (family members), and on the other hand, it affords a sense of satisfaction to the nurses and contributes to the development of their professional independence. Conclusions: According to care providers, improving accessibility through increasing the number of contracted services as well as raising the pay for 1 day of care per patient may improve the functioning of LTHNC. Relevance to clinical practice: The results of our study are a source of information for those who organise health care and administer resources on how to improve the functioning of LTHNC. [ABSTRACT FROM AUTHOR]

Aim: The objective was to test how nurse burnout impairs day-to-day adaptive self-regulation strategies that link levels of regulatory resources with employee job performance. Background: Regulatory resources help employees manage their thoughts, feelings, and behaviours on a daily basis. On days when these resources are low, employees may engage in maladaptive self-regulation: more self-undermining (i.e. creating additional obstacles) and less job crafting (i.e. optimizing job demands and resources), which debilitates their work performance. We expected that self-regulation is impaired especially when individuals exhibit low motivation and low ability to regulate their behaviour, that is, when they experience elevated burnout. Design: This research used a daily diary design. Nurses responded to a general survey and then completed daily diary surveys in three different moments: before, during and after work for 10 consecutive workdays (total reports N = 732). Method: A sample of 81 nurses from Polish hospitals and primary healthcare centres com pleted self-reported questionnaires between January and March 2018. Hypotheses were tested using multilevel modelling in Mplus. Results: Momentary self-regulatory capacity before work was negatively related to self-undermining and positively related to job crafting, and it indirectly predicted daily job performance. As hypothesized, these indirect relationships were moderated by general, chronic burnout. We found that only for employees with low levels of burnout, daily self-regulation was linked with better functioning via increased job crafting and decreased self-undermining. Conclusion: Chronic burnout disturbs day-to-day behaviour regulation. Individuals with elevated burnout symptoms have difficulty to translate momentary boosts in regulatory resources into adaptive strategies that are linked with higher performance. Impact: Our findings call for better recovery programmes, strategic Human Resource Management practices aimed at reducing factors that deplete daily self-regulatory resources, and finally top-down interventions preventing burnout among employees in the healthcare system. [ABSTRACT FROM AUTHOR]

Aim and objectives: To compare the self‐reported level of professionalism among nurses in Poland and Belarus and to indicate the areas in which differences in professional behaviours of nurses in both countries exist. Background: Nurses constitute the largest group of healthcare providers, and the term professionalism is closely related to nursing profession. Design: This investigation is a comparative survey and descriptive analysis of professional behaviours among nurses in Poland (n = 205) and Belarus (n = 236). The study was reported according to the STROBE checklist. Methods: The Professionalism in Nursing Behaviors' Inventory Image Survey adapted from Adams and Miller (2001) was used to collect the data. The questionnaire contains 46 questions addressing the following behavioural categories: educational preparation, publications, research, professional organisation, community service, competence, code for nurses, theory and autonomy. Results: The mean total score of professionalism was significantly different between the two countries (p <.0001). Significant differences, with higher scores in the group of respondents from Belarus, were also revealed in the following subscales of professionalism: "Professional organisation," "Community service," "Competence" and "Publication." Nurses from Poland had higher levels of "Educational preparation" and "Use of theory." No statistically significant differences were indicated in the "Autonomy" and "Research" subscales. Conclusion: Differences in the professionalism level of nurse practitioners in Poland and Belarus are related to nurses' professional position and the context in which they practice. Relevance to clinical practice: The results of the present study can help the healthcare management and nursing leaders to support the professional development of nurses and strive for a higher level of professionalism. [ABSTRACT FROM AUTHOR]

Aims and objectives: To examine the association between registered nurses' (referred to as "nurses" for brevity) shifts of 12 hr or more and presence of continuing educational programmes; ability to discuss patient care with other nurses; assignments that foster continuity of care; and patient care information being lost during handovers. Background: The introduction of long shifts (i.e., shifts of 12 hr or more) remains controversial. While there are claims of efficiency, studies have shown long shifts to be associated with adverse effects on quality of care. Efficiency claims are predicated on the assumption that long shifts reduce overlaps between shifts; these overlaps are believed to be unproductive and dangerous. However, there are potentially valuable educational and communication activities that occur during these overlaps. Design: Cross‐sectional survey of 31,627 nurses within 487 hospitals in 12 European countries. Methods: The associations were measured through generalised linear mixed models. The study methods were compliant with the STROBE checklist. Results: When nurses worked shifts of 12 hr or more, they were less likely to report having continuing educational programmes; and time to discuss patient care with other nurses, compared to nurses working 8 hr or less. Nurses working shifts of 12 hr or more were less likely to report assignments that foster continuity of care, albeit the association was not significant. Similarly, working long shifts was associated with reports of patient care information being lost during handovers, although association was not significant. Conclusion: Working shifts of 12 hr or more is associated with reduced educational activities and fewer opportunities to discuss patient care, with potential negative consequences for safe and effective care. Relevance to clinical practice: Implementation of long shifts should be questioned, as reduced opportunity to discuss care or participate in educational activities may jeopardise the quality and safety of care for patients. [ABSTRACT FROM AUTHOR]

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Aims and objectives: An important question is whether frailty syndrome affects the assessment of quality of life or whether frailty syndrome may reduce the benefits of a cardiac pacemaker implantation. Background: Frailty syndrome is known risk factor for quality of life evaluation after selected cardiology invasive procedures. Design: The study was designed as single-centre prospective study. Methods: The study included 171 patients aged ≥60 years who were qualified for pacemaker implantation. Quality of life was evaluated twice—before and 6 months after implantation using MLHF questionnaire. A frailty syndrome evaluation using the Tilburg Frailty Indicator (TFI) was performed prior to pacemaker implantation. A DDDR pacemaker was implanted in each patient. Results: Frailty syndrome was identified in half of the patients with indications for cardiac pacemaker implantation. There was an improvement in quality of life in the six months after pacemaker implantation in all of the robust and frailty syndrome affected patients that were included into the study—in general, physical and emotional domains. Conclusion: Implantation of cardiac pacemaker influences the compensation quality of life evaluation in patients with sinus node dysfunction. Presence of frailty influences worse quality of life of patients when evaluated before cardiac pacemaker implantation. Relevance to clinical practice: Frailty should be evaluated in all older patients qualified for pacemaker implantation to evaluate high-risk group, optimise therapeutic approach and to intense education activities for patients and family. [ABSTRACT FROM AUTHOR]

Background Acceptance of illness is a significant determinant of further coping with a disease. Development of illness acceptance may be associated with the sense of coherence and perception of social support. Cancer is an example of a crisis situation, which affects both the patient and his/her close relatives. Consequently, acceptance of illness may be influenced by factors originating from both sides of caregiver-patient dyad. The aim of this study was to analyse direct and indirect interrelationships between perceived support and the sense of coherence in patient-caregiver dyad, and acceptance of illness in cancer patients. Design Cross-sectional study. Methods The study included 80 dyads composed of cancer patients and their caregivers. Only cancer patients undergoing oncological treatment at the time of the study, for at least 3 months but no longer than 12 months, were enrolled. All subjects completed perceived support subscale included in the Berlin Social Support Scales, sense of coherence-29 questionnaire to determine the sense of coherence and Acceptance of Illness Scale. Results Compared to cancer patients, their caregivers presented with significantly lower levels of perceived social support and weaker sense of coherence. The sense of coherence in caregivers and patients was determined by their perceived support levels. The sense of coherence in caregivers turned out to be a key resource influencing acceptance of illness in cancer patients, both directly and indirectly, via their perceived social support and their sense of coherence. Conclusions The sense of coherence, an intrinsic psychological factor determined by social support, is an important determinant of illness acceptance. Functioning of cancer patients is also modulated by psychosocial characteristics of their caregivers. Relevance to clinical practice Greater support offered to caregivers may substantially strengthen the sense of coherence in caregivers and cancer patients and, therefore, may improve the functioning of patient-caregiver dyad in a situation of neoplastic disease. [ABSTRACT FROM AUTHOR]

Aims and objectives The aim of this study was to identify the potential risk factors for the development of post-traumatic stress disorder in mothers and fathers following infant hospitalisation in the neonatal intensive care unit. Background The development of neonatal intensive care units has increased the survival rate of infants. However, one of the major parental problems is post-traumatic stress disorder. Design An observational study covered 125 parents (72 mothers and 53 fathers) of infants aged 3-12 months who were hospitalised in the neonatal intensive care unit during the neonatal period. Setting Third-referral neonatal intensive care unit. Several standardised and self-reported research tools were used to estimate the level of post-traumatic stress symptoms (Impact Event Scale-Revised), perceived stress (Perceived Stress Scale) and coping strategies (COPE Inventory). The respondents also completed a Parent and Infant Characteristic Questionnaire. Results The mothers and fathers did not differ in their parental and infant characteristics. Post-traumatic stress disorder was present in 60% of the mothers and 47% of the fathers. Compared to the fathers, the mothers felt greater stress ( p = .020) and presented a higher severity of post-traumatic stress disorder ( p < .001). Previous miscarriages ( p = .023) and the presence of chronic diseases ( p = .032) were risk factors for post-traumatic stress disorder in the mothers. In the fathers, an Apgar test at 1 min after birth ( p = .030) and a partner's post-traumatic stress disorder ( p = .038) were related to post-traumatic stress disorder. The mothers compared to the fathers were more likely to use strategies such as: positive reinterpretation and growth, focusing on and venting of emotions, instrumental social support, religious coping and acceptance. In the fathers, the predictors included an Apgar score at 1 min after birth, a lack of congenital anomalies in the child and mental disengagement. Conclusion Risk factors for post-traumatic stress disorder, as well as coping strategies, differ in women compare to men. Relevance to clinical practice Knowledge of risk factors for post-traumatic stress disorder, specific to men and women, may help identify the parents in whom probability of the occurrence of this disorder is increased. [ABSTRACT FROM AUTHOR]

Aims and objectives To identify the quality of life of patients with diabetic foot ulcers in the Visegrad countries. Background The diabetics with foot ulcers are principally evaluated on the basis of physical parameters, but this does not always reveal much about the patient's experience of life with ulceration. Design The cross-sectional study. Methods The standardised generic questionnaire World Health Organization Quality of Life- BREF was used. The sample was made up of 525 participants and the calculations were performed using the IBM spss statistical program. Results The significant negative correlations between demographic data such as age, duration of diabetes mellitus, duration of diabetic ulceration treatment and a lower level of quality of life were found across the sample. The statistically significant differences according to clinical characteristics such as Wagner classification, frequency of foot ulcers, present peripheral vascular disease and pain in terms of quality of life were also revealed. Significant differences of quality of life among Visegrad countries were revealed: Hungary's participants had a worse quality of life than others, while Slovak participants expressed lower satisfaction with their health than Czech. Conclusions Socio-demographic factors and clinical characteristics influence the quality of life of patients with diabetic foot ulcer. Significant differences between patients of Visegrad countries were found in all domains of quality of life: physical, psychological, social and environmental. Relevance to clinical practice The quality of life of patients with diabetic foot ulcer reflects the conditions and healthcare system in each of the Visegrad countries. We have to respect socio-demographic factors and clinical characteristics in nursing care. This could have an impact on managing patient care not only with regard to their diabetic foot ulcer but also with regard to the patient as a personality with their own problems in relation to physical, psychosocial and environmental conditions. [ABSTRACT FROM AUTHOR]

Aims and objectives This study aimed to assess the reasons and the frequency of the use of over-the-counter ( OTC) nonsteroidal anti-inflammatory drugs ( NSAIDs) or analgesics by liver transplant recipients ( LTR). Patient awareness of possible drug-related side-effects was also assessed. Background NSAIDs and analgesics available without prescription belong to the most commonly used class of drugs. However, use of these drugs might be complicated by toxic adverse effects ( AEs). Patients at risk for AEs include the transplant recipients. Design/methods This was a descriptive study. An anonymous survey was carried out in 73 randomly selected LTR, who represented 10% of all LTR at our centre. Results There were 64% of the patients who confirmed taking NSAIDs or analgesics; 16% of these patients took these drugs at least several times a week and 10% took them daily. For 39% of patients, the only way to manage their pain were OTC NSAIDs or analgesics. As many as 36% of patients were unaware of the risks associated with the use of these drugs. Ninety per cent of LTR consider physicians the most trusted source of drugs information. Conclusions Our study shows that two-thirds of LTR take OTC NSAIDs or analgesics and one-third are unaware of the AEs associated with these drugs. Therefore, both transplant nurses and doctors should educate their patients about the use and possible AE of these drugs. Relevance to clinical practice Considering the high NSAIDs consumption rates, the side effects of these drugs should always be suspected. Especially in patients taking these drugs and referring to medical advisors with specific symptoms, such as: abdominal pain, anaemia, elevated serum creatinine concentration or liver enzymes activity. Awareness of the scale of the problem enables health professionals to cooperate in educating patients. Such practices may reduce uncontrolled abuse of these drugs and related health care costs. [ABSTRACT FROM AUTHOR]